When did teen dating get so violent? It used to be the kind of thing that was a plot linchpin for movies but now estimates are that 1 in 6 young people report acts like punching, pulling hair, shoving, and throwing things.

The good news for equality is that both genders do it, they are aggressors and victims - and sometimes both.

Do you believe it? Surveys are difficult at best and surveys of teenagers are more prone to inconsistency so calibrate accordingly, but the University of Michigan Medical School used surveys of just over 4,000 adolescent patients ages 14 to 20 seeking emergency care, a much different circumstance than questions posted on the Internet.

They found that those with depression or a history of using drugs or alcohol had a higher likelihood of being an aggressor or victim.

Health care visits may be key opportunities for screening and intervention when it comes to teen violence. Credit: University of Michigan/Thinkstock

"It's important to think about both genders when trying to identify teen dating violence, especially when there are other conditions we may be trying to assess in the health care setting," says Vijay Singh, M.D., MPH, MS, the study's lead author. "These data remind us that teen relationships are not immune to violence and should encourage providers to ask adolescent patients about this important issues. In addition, this could help us understand whom to target for screening and referral to, or development of, programs that could help them."

Singh and colleagues analyzed data from a larger survey of teens and young adults aged 14 to 20 years who visited the U-M Health System's emergency department for any reason between late 2010 and early 2013. The teens took the surveys on touch-screen tablet computers in private, though those under age 18 needed their parents' consent to take part.

In all, 1 in 5 young women said they had been the victim or aggressor in a violent situation in the last year with a romantic partner, and 1 in 8 young men reported the same, suggesting that Emergency Departments can aid in identifying dating violence.Teen girls who had sought emergency care for an intentional injury in the last year had twice the odds of reporting violence in their dating relationships.

The lack of data on men as both victims and aggressors means there isn't a similar recommendation for screening them. The new study, he hopes, will add to the understanding of how dating violence affects young men.

"This affects people of both genders, so let's assess them both," Singh says. "Especially in the teen years, when young people are figuring out their relationship roles, changing partners more often than adults, and likely not living together."